Osteoid osteoma of the pisiform: A case report

Surgical Management of Triquetral Osteoid Osteoma with Adjunct Tetracycline for Intraoperative Visualization: A Case Report

CASE

We report the case of a 15-year-old male patient presenting with persistent wrist pain after surgical treatment of a triquetral osteoid osteoma. The patient was found to have a persistent nidus. These tumors are difficult to observe intraoperatively or through fluoroscopy, limiting adequate resection and resulting in continued pain.

CONCLUSION

The nidus was excised successfully through an unusual technique using tetracycline for intraoperative identification. The patient remains asymptomatic without recurrence at 31 months postoperative. Difficulties visualizing and removing carpal lesions leading to recurrence are described.

Hypertrophic Pisiform: A Case of Osteoid Osteoma

We treated an extremely rare case of osteoid osteoma of the pisiform. Pisiform hypertrophy caused persistent pain and ulnar nerve irritation at Guyon's canal after the initial trauma. The re-enlargement of the pisiform attracted our attention allowing us to ultimately diagnose the condition as osteoid osteoma and treat the patient with a successful clinical result.

Osteoid osteoma of the pisiform: A case report

BACKGROUND

Osteoid osteoma is an uncommon benign bone-forming tumor of the musculoskeletal system but it is the most common primary bone tumor of the carpal region. However, only seven cases of its pisiform involvement have been described.

CASE

We present a 19 year-old male patient with osteoid osteoma of the pisiform which initially could not be detected in any diagnostic study for long standing wrist pain. The patient was treated with excision and curettage. In 1 year of follow-up, the patient was asymptomatic without recurrence.

CONCLUSION

In cases with long standing ulnar wrist pain, one should consider osteoid osteoma of the pisiform in differential diagnosis. If an OO is suspected, thin slice CT scan in initial evaluation would be valuable in preventing the patient from misdiagnosis or delay in diagnosis.

Osteoid osteoma of the pisiform. Can it exist in a child?

Carpal osteoid osteomas are extremely rare, and only six cases in the pisiform have ever been described, but all concerned exclusively adults. We have treated a unique case of osteoid osteoma in the pisiform of a 13-year-old girl. We excised en bloc the nidus, which resulted in total excision of the pisiform. At follow-up after 15 years there was no recurrence and the patient remains asymptomatic with equal functionality of both hands. Henceforth, we must include osteoid osteoma in the differential diagnosis of pisiform lesions in children. En bloc resection prevents its recurrence and even the complete pisiform excision renders excellent results.